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PF and massage

Posted by John in Santa Cruz on 10/08/02 at 11:51 (097079)

Hi guys. First timer on this board, but lots of experience with PF. I was a professional long distance runner and developed PF in college as a result of overuse, etc. I took a long layoff, gained some weight, but have been back at it now January (minus about 25 lbs of lard, yea!). Of course, my PF has come back, I am beginning to aggressively manage on my own. I run about 40 miles per week, fairly hard. My form of PF is not as bad as some of those I have read about on this board. Classically bad in a.m. or after sitting for extended period, but it loosens up and after about 3-4 mins. running am relatively pain free and can run without modifying my stride. My aspiration though is to get back to a level where I can be a nationally competitive masters runner. I am 43. Being able to run is very important to me and is a significant quality of life factor for me.

My question for you guys is on the value of massage therapy. I beginning to really question it and think it may actually be counter productive. My experience on several ocassions, including recently, is that it actually seems to make my PF WORSE. For years have speculated that the massages I was got from the professionals at Nike were responsible for dramatic degradation of my condition and ultimate end of my athletic career. The other day, I decided to go for a massage, very easy on the feet and boom, it happened again!

Has anyone else had this experience? Is there a secret to PF massage, like staying away from the heal area that is injured, maybe focus on the calf (thanks to this board for the tip on calf flexibility by the way). In the past tape and arch support were magic for me, I am heading down to the drug store today for athletic tape and inserts. Shall I lay off massage?

John

Re: PF and massage

Ed Davis, DPM on 10/08/02 at 15:05 (097086)

Excellent observations. Vigorous massage and deep tissue massage should be used on the tissue that is not inflamed.
Ed

Re: PF and massage

John in Santa Cruz on 10/08/02 at 15:58 (097093)

Thanks Doc. I wish I knew more about this 15 years ago. The 'pros' at N*** thought the way to treat pf was through a deep tissue massage targeting the inflamed area. After about a month of this I was almost completely debillitated. My feeling about sports massage is that it has to be used very carefully, whether for pf or anything else.

Re: PF and massage

pala on 10/08/02 at 19:16 (097107)

i used to live in santa cruz/ great place. i used to unwind in the kiva, stretch out calves in hot water

Re: PF and massage-I find it HELPFUL

Mahatmelissama on 10/09/02 at 12:39 (097140)

Hi John,

I live over the hill from you and my massage therapist practices in Campbell but she lives in Santa Cruz.

I find a total body massage really helps me. My therapist [Donna Staunton] though listens to me...if something hurts, she stops immediately. She has only been allowed by me to massage my left foot recently since my left foot has PF really bad. I am healing slowly by SDO (Silicon Dynamic Orthotics advertised on Scott's main page here), losing weight (only lost about 20 in one year but going for more...on Weight Watchers), going to a good chiropractor who practices on Hedding near Saratoga [Dr. Richard Gohrman]. I don't do much stretching since it always makes my PF worse. Instead I try to remember to pull back my toes...flex my feet and sort of 'pinch' the sensitive spots (holding pressure down).

I would love to be able to stand in Trader Joes for more than 5 minutes in line...let alone jog.

Happy Healing to you and Blessings.

Re: PF and massage-I find it HELPFUL

John in Santa Cruz on 10/09/02 at 13:35 (097145)

Thanks for your comments. My first experience with supposed professional sports massage people was that it wasn't doing any good UNTIL it hurt. The Bad Old Days I guess.

I agree, the full body massage is in general helpful to me as well. I was refering to the deep tissue massage of the inflamed area in the heel specifically which at least SEEMS to be counterproductive. Sounds like you have been avoiding that area altogether, I think with good reason. Am going to ask my therapist to not touch the heel area and see how that goes. As for the rest of the body, I am a big advocate of massage. Just not from a quack.

I feel like a bit of a wimp for even complaining about my situation given the very debillitating pain that many on this board experience. While mine is chronic and can impinge on an activity important to me, I can pretty much get around normal life with nothing but moderate discomfort. For example, I taped up last night and it made a WORLD of difference for me immediately. Nearly pain free on a hard 4 miler this a.m.

This tape job is different than the one demonstrated on the website. You start with tape on the ball of the foot behind the big toe, loop it behind the heel and back up to the ball of the foot. Then you apply overlapping straps across the entire length of the foot, finishing with a single strap over the top at the arch. You have to keep your toes and foot really pulled back while applying the tape. It is really hard to get right by yourself. The first time I had this I was in very bad shape, stepped off the trainers table it was like he had performed a miracle.

Explain to me more about the 'pinching' of sensitive spots you do.

Re: Reply to you, John in Santa Cruz

Mahatmelissama on 10/09/02 at 14:52 (097148)

Ok...I see what you mean. Deep tissue massage would definitly be a no-no for me...I would be homicidal toward anyone who tried to deep massage my foot..I PITY DA FOOL!

Re: the chiropractor when you say 'quack', I understand your possibly negative view of chiropractors. I must tell you I was raised by a Neurologist (my mother). She is suspicious of chiropractors since some of her patients have been hurt by them (mainly telling her patients 'don't see a medical doctor'. She does however not have a problem if they help a client, relieving them of pain.

I went to see my chiropractor with a lot of heatlhy skeptism and FEAR. I would not let him adjust my foot on first visit...so he put an electrical stimulator on it. I found out later from my mom that these are used in the medical profession to stimulate muscles. My foot improved even the first visit. I live his office feeling better...or better after a day of soreness, so I keep returning. He is only $40.00 a pop. My horror story of the HMO hassle and apatethic podiatrist drove me to seek him [the chirpractor] out.

To answer your question on pinching...It is taking your foot in your hand (you sit on floor Indian style) and pressing down just below area below toes (in arch area)...then also that area. It is to help break up scar tissue. I also use frequently a massager machine to massage feet and put heat on them...similar thing.

Re: PF and massage

R C on 10/09/02 at 15:53 (097152)

John,

This will probably sound like heresy to the ears of a professional runner, but I urge you in the strongest possible terms to stop running altogether until the PF is absolutely gone. You do not want to wake up one day and discover that your relatively minor case of PF has erupted into an oppressive, debiliating, and seemingly incurable case (as so many of the other readers have suffered through). It just isn't worth it. If even moderate massage causes your foot to ache, I can only imagine what 40 miles of pounding per week could do. Try swimming in the mean time (another heresy, I suppose).

Good luck in any case--

Re: PF and massage-I find it HELPFUL

Carole C in NOLA on 10/09/02 at 19:37 (097166)

Mahatmelissama, I know how you feel about wanting to stand in Trader Joes for more than 5 minutes. I feel certain that some day you will be able to stand in line for as long as you want.

It takes time, and lots of it unfortunately. But when you heal and feel better, these times will slip away from your memory and it will all seem like an old nightmare that you don't have any more.

By the way, you are so LUCKY to have Trader Joes! And I can also imagine how frustrating it must be to not be able to go there. I hope someday they open one in Louisiana or Mississippi so that I can see all the great nutritious foods I keep hearing about at Trader Joes.

Carole C

Re: PF and massage

Ellen J. on 10/09/02 at 19:49 (097167)

I have had P.F. for 3 yrs. and used to run but had to stop when the injury occurred. I found that the massage that the physical therapist did was detrimental to my recovery and I stopped going to P.T. I discovered that the best thing for me was not to do anything that caused pressure or strain on the feet and finally my feet are pain-free when I walk (but I can't do anything more than walk yet).
I just went to a sports medicine/chiropractor who gave me a good explanation about the inflammation/scar tissue/adhesion/massage thing. He told me that initially, P.F. is purely inflammation but that if not dealt with quickly, scar tissue adhesions appear, causing a cycle of inflammation,more scarring, etc. The deep massage is designed to break up the disorganized scar tissue and realign it so it's more like normal tissue and less prone to ripping (and more inflmmation). However, he said, the massage does not work well for everyone. He said that some people do get worse from the massage. I told him I was one of those, and we agreed that he would not do massage on my feet. However, what he is doing instead is 'Triggor Point Therapy' on my calves, hamstrings, hips, etc. to loosen up my muscles. I don't know if it will work, but I figured I would try it. Although he is also a chiropractor, he said that the need for spinal adjustments was not all that common, and in my case not necessary. My biggest problem is that I'm tight and inflexible from 3 yrs of very little exercise so he's working to help me regain the flex. I am thinking that your thoughts on slowly stretching out the calves might be a better idea for you rather than massage on the feet.
The next question I plan to ask the doctor (at my first P.T. appt.) is whether the stretching of calves, hamstrings, etc. will, over a long period of time, realign the scar tissue in the feet the same way deep massage might do in a short time. That's just a hypothesis on my part but I'll be interested to hear his answer.
I too am 43 and don't feel like I'm old enough to be so inactive but am working at rehabbing myself slowly and carefully.
I hope you can get back to running with no more injuries.
Ellen J.

Re: PF and massage-I find it HELPFUL

nancy s. on 10/09/02 at 21:21 (097169)

who is this Trader Joe guy, and what does he sell? i don't think he's been to maine yet.

of course, maine just got its first retail store two weeks ago, so we're behind on the consumer front.

just kidding!

nancy

Re: Massage update

John in Santa Cruz on 10/10/02 at 14:35 (097245)

Thanks to all for your thoughts on this. Pretty much confirms my personal experience. The update is that I have been going back to my 'aggressive' treatment protocol, including tape and ice, adding quite a bit of stretching, esp. non-weightbearing Julie stretches. Am not letting massage therapist touch heels until I can dig in without pain myself. So far though, I'm having encouraging results. After just a few days I barely feel it when I get out of bed and there is virtually no pain at the start of run or during. This accomplished without anti-inflamatories so far. Ran 5 miles this morning in less than 32:00, and virtually no pain after sitting the morning.

Thanks to you all though, I think I have learned a lesson about real active management of this, rather than just hobbling along and trying to 'run through' the pain as I would have in college. I am taking my pf much more seriously these days.

Thanks.

John

Re: Massage update

Mahatmelissama on 10/14/02 at 11:37 (097470)

As the eagles say...'take it easy' [on thoese feet running!] ;)

I am glad that you are having some success John in Santa Cruz.

I hope someday I too will be able to run again.

Re: PF and massage

Ed Davis, DPM on 10/15/02 at 20:56 (097578)

Your chiropractor is on the right track. The three components of plantar fasciitis treatment: inflammation - the primary problem early on, biomechanics -- problem biomechanics causes PF to persist, tissue quality -- poor tissue quality is the results of long term chronic inflammation.
Ed

Re: PF and massage

Ed Davis, DPM on 10/08/02 at 15:05 (097086)

Excellent observations. Vigorous massage and deep tissue massage should be used on the tissue that is not inflamed.
Ed

Re: PF and massage

John in Santa Cruz on 10/08/02 at 15:58 (097093)

Thanks Doc. I wish I knew more about this 15 years ago. The 'pros' at N*** thought the way to treat pf was through a deep tissue massage targeting the inflamed area. After about a month of this I was almost completely debillitated. My feeling about sports massage is that it has to be used very carefully, whether for pf or anything else.

Re: PF and massage

pala on 10/08/02 at 19:16 (097107)

i used to live in santa cruz/ great place. i used to unwind in the kiva, stretch out calves in hot water

Re: PF and massage-I find it HELPFUL

Mahatmelissama on 10/09/02 at 12:39 (097140)

Hi John,

I live over the hill from you and my massage therapist practices in Campbell but she lives in Santa Cruz.

I find a total body massage really helps me. My therapist [Donna Staunton] though listens to me...if something hurts, she stops immediately. She has only been allowed by me to massage my left foot recently since my left foot has PF really bad. I am healing slowly by SDO (Silicon Dynamic Orthotics advertised on Scott's main page here), losing weight (only lost about 20 in one year but going for more...on Weight Watchers), going to a good chiropractor who practices on Hedding near Saratoga [Dr. Richard Gohrman]. I don't do much stretching since it always makes my PF worse. Instead I try to remember to pull back my toes...flex my feet and sort of 'pinch' the sensitive spots (holding pressure down).

I would love to be able to stand in Trader Joes for more than 5 minutes in line...let alone jog.

Happy Healing to you and Blessings.

Re: PF and massage-I find it HELPFUL

John in Santa Cruz on 10/09/02 at 13:35 (097145)

Thanks for your comments. My first experience with supposed professional sports massage people was that it wasn't doing any good UNTIL it hurt. The Bad Old Days I guess.

I agree, the full body massage is in general helpful to me as well. I was refering to the deep tissue massage of the inflamed area in the heel specifically which at least SEEMS to be counterproductive. Sounds like you have been avoiding that area altogether, I think with good reason. Am going to ask my therapist to not touch the heel area and see how that goes. As for the rest of the body, I am a big advocate of massage. Just not from a quack.

I feel like a bit of a wimp for even complaining about my situation given the very debillitating pain that many on this board experience. While mine is chronic and can impinge on an activity important to me, I can pretty much get around normal life with nothing but moderate discomfort. For example, I taped up last night and it made a WORLD of difference for me immediately. Nearly pain free on a hard 4 miler this a.m.

This tape job is different than the one demonstrated on the website. You start with tape on the ball of the foot behind the big toe, loop it behind the heel and back up to the ball of the foot. Then you apply overlapping straps across the entire length of the foot, finishing with a single strap over the top at the arch. You have to keep your toes and foot really pulled back while applying the tape. It is really hard to get right by yourself. The first time I had this I was in very bad shape, stepped off the trainers table it was like he had performed a miracle.

Explain to me more about the 'pinching' of sensitive spots you do.

Re: Reply to you, John in Santa Cruz

Mahatmelissama on 10/09/02 at 14:52 (097148)

Ok...I see what you mean. Deep tissue massage would definitly be a no-no for me...I would be homicidal toward anyone who tried to deep massage my foot..I PITY DA FOOL!

Re: the chiropractor when you say 'quack', I understand your possibly negative view of chiropractors. I must tell you I was raised by a Neurologist (my mother). She is suspicious of chiropractors since some of her patients have been hurt by them (mainly telling her patients 'don't see a medical doctor'. She does however not have a problem if they help a client, relieving them of pain.

I went to see my chiropractor with a lot of heatlhy skeptism and FEAR. I would not let him adjust my foot on first visit...so he put an electrical stimulator on it. I found out later from my mom that these are used in the medical profession to stimulate muscles. My foot improved even the first visit. I live his office feeling better...or better after a day of soreness, so I keep returning. He is only $40.00 a pop. My horror story of the HMO hassle and apatethic podiatrist drove me to seek him [the chirpractor] out.

To answer your question on pinching...It is taking your foot in your hand (you sit on floor Indian style) and pressing down just below area below toes (in arch area)...then also that area. It is to help break up scar tissue. I also use frequently a massager machine to massage feet and put heat on them...similar thing.

Re: PF and massage

R C on 10/09/02 at 15:53 (097152)

John,

This will probably sound like heresy to the ears of a professional runner, but I urge you in the strongest possible terms to stop running altogether until the PF is absolutely gone. You do not want to wake up one day and discover that your relatively minor case of PF has erupted into an oppressive, debiliating, and seemingly incurable case (as so many of the other readers have suffered through). It just isn't worth it. If even moderate massage causes your foot to ache, I can only imagine what 40 miles of pounding per week could do. Try swimming in the mean time (another heresy, I suppose).

Good luck in any case--

Re: PF and massage-I find it HELPFUL

Carole C in NOLA on 10/09/02 at 19:37 (097166)

Mahatmelissama, I know how you feel about wanting to stand in Trader Joes for more than 5 minutes. I feel certain that some day you will be able to stand in line for as long as you want.

It takes time, and lots of it unfortunately. But when you heal and feel better, these times will slip away from your memory and it will all seem like an old nightmare that you don't have any more.

By the way, you are so LUCKY to have Trader Joes! And I can also imagine how frustrating it must be to not be able to go there. I hope someday they open one in Louisiana or Mississippi so that I can see all the great nutritious foods I keep hearing about at Trader Joes.

Carole C

Re: PF and massage

Ellen J. on 10/09/02 at 19:49 (097167)

I have had P.F. for 3 yrs. and used to run but had to stop when the injury occurred. I found that the massage that the physical therapist did was detrimental to my recovery and I stopped going to P.T. I discovered that the best thing for me was not to do anything that caused pressure or strain on the feet and finally my feet are pain-free when I walk (but I can't do anything more than walk yet).
I just went to a sports medicine/chiropractor who gave me a good explanation about the inflammation/scar tissue/adhesion/massage thing. He told me that initially, P.F. is purely inflammation but that if not dealt with quickly, scar tissue adhesions appear, causing a cycle of inflammation,more scarring, etc. The deep massage is designed to break up the disorganized scar tissue and realign it so it's more like normal tissue and less prone to ripping (and more inflmmation). However, he said, the massage does not work well for everyone. He said that some people do get worse from the massage. I told him I was one of those, and we agreed that he would not do massage on my feet. However, what he is doing instead is 'Triggor Point Therapy' on my calves, hamstrings, hips, etc. to loosen up my muscles. I don't know if it will work, but I figured I would try it. Although he is also a chiropractor, he said that the need for spinal adjustments was not all that common, and in my case not necessary. My biggest problem is that I'm tight and inflexible from 3 yrs of very little exercise so he's working to help me regain the flex. I am thinking that your thoughts on slowly stretching out the calves might be a better idea for you rather than massage on the feet.
The next question I plan to ask the doctor (at my first P.T. appt.) is whether the stretching of calves, hamstrings, etc. will, over a long period of time, realign the scar tissue in the feet the same way deep massage might do in a short time. That's just a hypothesis on my part but I'll be interested to hear his answer.
I too am 43 and don't feel like I'm old enough to be so inactive but am working at rehabbing myself slowly and carefully.
I hope you can get back to running with no more injuries.
Ellen J.

Re: PF and massage-I find it HELPFUL

nancy s. on 10/09/02 at 21:21 (097169)

who is this Trader Joe guy, and what does he sell? i don't think he's been to maine yet.

of course, maine just got its first retail store two weeks ago, so we're behind on the consumer front.

just kidding!

nancy

Re: Massage update

John in Santa Cruz on 10/10/02 at 14:35 (097245)

Thanks to all for your thoughts on this. Pretty much confirms my personal experience. The update is that I have been going back to my 'aggressive' treatment protocol, including tape and ice, adding quite a bit of stretching, esp. non-weightbearing Julie stretches. Am not letting massage therapist touch heels until I can dig in without pain myself. So far though, I'm having encouraging results. After just a few days I barely feel it when I get out of bed and there is virtually no pain at the start of run or during. This accomplished without anti-inflamatories so far. Ran 5 miles this morning in less than 32:00, and virtually no pain after sitting the morning.

Thanks to you all though, I think I have learned a lesson about real active management of this, rather than just hobbling along and trying to 'run through' the pain as I would have in college. I am taking my pf much more seriously these days.

Thanks.

John

Re: Massage update

Mahatmelissama on 10/14/02 at 11:37 (097470)

As the eagles say...'take it easy' [on thoese feet running!] ;)

I am glad that you are having some success John in Santa Cruz.

I hope someday I too will be able to run again.

Re: PF and massage

Ed Davis, DPM on 10/15/02 at 20:56 (097578)

Your chiropractor is on the right track. The three components of plantar fasciitis treatment: inflammation - the primary problem early on, biomechanics -- problem biomechanics causes PF to persist, tissue quality -- poor tissue quality is the results of long term chronic inflammation.
Ed